使用体积稳定的胶原基质或结缔组织移植物增加小颊侧骨缺损处种植体周围软组织：一项随机对照试验
Peri-Implant Soft Tissue Increase at Small Buccal Bone Dehiscences With Either Volume-Stable Collagen Matrix or Connective Tissue Graft: A Randomized Controlled Trial.
作者信息
Ferrarotti Francesco, Baima Giacomo, Mohammadi Giulia, Carboncini Clelia, Romano Federica, Aimetti Mario
机构信息
Department of Surgical Sciences, C.I.R. Dental School, University of Turin, Turin, Italy.
出版信息
Clin Oral Implants Res. 2025 Mar 19. doi: 10.1111/clr.14430.
OBJECTIVES
This randomized clinical study compared the profilometric measurements of the buccal tissue volume at sites augmented using a volume-stable collagen matrix (VCMX) or connective tissue graft (CTG) simultaneously to implant placement in the presence of small buccal bone dehiscence (SBBD ≤ 3 mm).
METHODS
Forty-four patients with SBBD were treated with soft tissue augmentation (STA) simultaneous to implant placement using VCMX or SCTG. Clinical measurements and 3D intraoral scans were collected prior to STA (BL), at 1, 3 months, and 1 year after prosthetic loading. Digital files were superimposed to compare profilometric volume on the buccal profile (primary outcome); peri-implant health, radiographic bone levels, and patient-reported outcome measures (PROMs) were also assessed.
RESULTS
Both treatments achieved a significant STA at 3 months, with a slight decrease observed from 1 month. At 3 months, the mean increase was 1.07 mm (SD 0.22) for VCMX and 1.22 mm (SD 0.44) for the CTG group (p = 0.156). PROMs revealed a difference in the perception of the bleeding at day 1, pain at 2 and 3 days, and swelling at 3 days favoring VCMX (p < 0.05). At 1 year, no intergroup difference in probing pocket depth, bleeding, and recession was detected, but CTG provided higher stability than VCMX in terms of profilometric measurements (0.21 mm [SD 0.32] vs. -0.05 mm [SD 0.36], respectively; p = 0.014) and radiographic bone levels (0.09 mm [SD 0.65] vs. -0.34 mm [SD 0.70]; p = 0.038).
CONCLUSION
For implant placement at posterior sites with small buccal bone dehiscences, CTG and VCMX resulted in an initially comparable volume augmentation and clinical parameters, with VCMX leading to better PROMs. At 1 year, CTG maintained slightly higher profilometric stability and bone levels.
TRIAL REGISTRATION
ClinicalTrials.gov identifier: NCT05466006 (https://classic.
CLINICALTRIALS
gov/ct2/show/NCT05466006).
目的
本随机临床研究比较了在存在小颊侧骨缺损（SBBD≤3mm）的情况下，使用体积稳定胶原基质（VCMX）或结缔组织移植（CTG）同时进行种植体植入时，颊侧组织体积的轮廓测量值。
方法
44例SBBD患者在种植体植入的同时使用VCMX或SCTG进行软组织增量（STA）。在STA前（基线）、修复体加载后1、3个月和1年收集临床测量数据和口腔三维扫描数据。将数字文件进行叠加，以比较颊侧轮廓上的轮廓测量体积（主要结果）；还评估了种植体周围健康状况、放射学骨水平和患者报告的结局指标（PROMs）。
结果
两种治疗方法在3个月时均实现了显著的STA，从1个月开始观察到略有下降。在3个月时，VCMX组的平均增加量为1.07mm（标准差0.22），CTG组为1.22mm（标准差0.44）（p=0.156）。PROMs显示，在第1天的出血感、第2天和第3天的疼痛以及第3天的肿胀方面存在差异，VCMX更具优势（p<0.05）。在1年时，未检测到两组在探诊深度、出血和退缩方面的差异，但在轮廓测量（分别为0.21mm[标准差0.32]和-0.05mm[标准差0.36]；p=0.014）和放射学骨水平（0.09mm[标准差0.65]和-0.34mm[标准差0.70]；p=0.038）方面，CTG比VCMX提供了更高的稳定性。
结论
对于在颊侧骨缺损较小的后部位置进行种植体植入，CTG和VCMX在初始时导致了相当的体积增加和临床参数，VCMX导致更好的PROMs。在1年时，CTG保持了略高的轮廓测量稳定性和骨水平。
试验注册
ClinicalTrials.gov标识符：NCT05466006（https://classic.
CLINICALTRIALS
gov/ct2/show/NCT05466006）。
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